Pub Date : 2025-09-01Epub Date: 2025-06-23DOI: 10.1016/j.metop.2025.100377
Yuriko Hajika, Yuji Kawaguchi
For optimal postprandial glucose (PPG) management, rapid-acting insulin analogs (RAA) should be administered 15 min before a meal; however, this may not be possible for some individuals. Ultra-rapid lispro (URLi) can be administered 0–2 min before or <20 min after a meal, which may improve patient satisfaction and PPG management. In this pilot study, we evaluated changes in quality of life (QOL) and glycemic management among Japanese outpatients with type 2 diabetes mellitus (T2DM) who switched from RAA to URLi. We enrolled 12 outpatients with T2DM and evaluated QOL using the insulin therapy-related (ITR) QOL questionnaire. The primary endpoint was the change in ITR-QOL scores at 12–15 weeks. Endpoints were evaluated using the one-sample Wilcoxon signed rank test or paired t-tests. URLi was associated with a significant increase in ITR-QOL (+15.1 ± 16.1 points, p < 0.01), perception (+7.2 ± 6.9 points, p < 0.01), and status (+7.9 ± 9.5 points, p < 0.05) scores. At 12–15 weeks, the time in range significantly increased (+8.3 ± 9.2, p < 0.05), time above range significantly decreased (−7.7 ± 10.2, p < 0.05), and time below range showed no significant changes. Thus, switching from RAA to URLi significantly improved ITR-QOL questionnaire scores. In summary, URLi is an effective treatment alternative, providing flexible timing, improved glycemic management, and enhanced patient satisfaction.
{"title":"Improved quality of life and glycemic management after switching from conventional rapid-acting insulin to ultra-rapid lispro in patients with diabetes","authors":"Yuriko Hajika, Yuji Kawaguchi","doi":"10.1016/j.metop.2025.100377","DOIUrl":"10.1016/j.metop.2025.100377","url":null,"abstract":"<div><div>For optimal postprandial glucose (PPG) management, rapid-acting insulin analogs (RAA) should be administered 15 min before a meal; however, this may not be possible for some individuals. Ultra-rapid lispro (URLi) can be administered 0–2 min before or <20 min after a meal, which may improve patient satisfaction and PPG management. In this pilot study, we evaluated changes in quality of life (QOL) and glycemic management among Japanese outpatients with type 2 diabetes mellitus (T2DM) who switched from RAA to URLi. We enrolled 12 outpatients with T2DM and evaluated QOL using the insulin therapy-related (ITR) QOL questionnaire. The primary endpoint was the change in ITR-QOL scores at 12–15 weeks. Endpoints were evaluated using the one-sample Wilcoxon signed rank test or paired <em>t</em>-tests. URLi was associated with a significant increase in ITR-QOL (+15.1 ± 16.1 points, <em>p</em> < 0.01), perception (+7.2 ± 6.9 points, <em>p</em> < 0.01), and status (+7.9 ± 9.5 points, <em>p</em> < 0.05) scores. At 12–15 weeks, the time in range significantly increased (+8.3 ± 9.2, <em>p</em> < 0.05), time above range significantly decreased (−7.7 ± 10.2, <em>p</em> < 0.05), and time below range showed no significant changes. Thus, switching from RAA to URLi significantly improved ITR-QOL questionnaire scores. In summary, URLi is an effective treatment alternative, providing flexible timing, improved glycemic management, and enhanced patient satisfaction.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100377"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144471445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-09-03DOI: 10.1016/j.metop.2025.100394
Dimitrios Tsilingiris , Theodora Stratigou , Dimitrios Kounatidis , Natalia G. Vallianou , Irene Karampela , Maria Dalamaga
Background
Subclinical hypothyroidism (SH) has been linked to an increased cardiovascular risk, though the specific contributing factors remain unclear.
Methods
We studied 120 consecutive adults with SH and 120 euthyroid controls matched for age, gender, and date of blood draw. Smoking status did not differ between groups. Groups were compared on clinical and laboratory data, lipid, insulin resistance (IR), glycemic, and liver steatosis/fibrosis indices, 10-year and lifetime cardiovascular risk (SCORE2, LIFE-CVD), as well as atherogenic and additional markers (lipoprotein(a), homocysteine, fibrinogen, highly sensitive C-reactive protein, apolipoproteins A1/B). A subset of individuals with SH and ≥TSH ≥10 mIU/L (n = 16) was followed up after L-thyroxine supplementation.
Results
SH subjects had a more adverse cardiovascular profile, with worse lipid, glycemic, IR, and hepatic markers, and higher 10-year (5.3 % vs. 4.1 % and 3.8 % vs. 2.8 %) and lifetime (28.5 % vs. 23.0 %) cardiovascular risk (all p < 0.05). Complementary markers were also elevated in SH (p < 0.01). Estimated absolute risk reductions from atorvastatin 20 mg were greater in SH (1.3 % vs. 0.9 % p = 0.008 and 7.7 % vs. 6.2 %, p < 0.001). The differences were more pronounced in severe SH (TSH ≥10). L-thyroxine led to modest risk amelioration (−0.21 % and −1.18 %), primarily owing to total/LDL cholesterol reductions.
Conclusions
SH is linked to a more adverse cardiovascular, metabolic and hepatic profile, indicating its potential as a candidate risk modifier. Intensive risk factor management is warranted, along with L-thyroxine supplementation in selected cases.
{"title":"Cardiometabolic risk profiles in subclinical hypothyroidism, and the potential impact of statin therapy: A cross-sectional and longitudinal study","authors":"Dimitrios Tsilingiris , Theodora Stratigou , Dimitrios Kounatidis , Natalia G. Vallianou , Irene Karampela , Maria Dalamaga","doi":"10.1016/j.metop.2025.100394","DOIUrl":"10.1016/j.metop.2025.100394","url":null,"abstract":"<div><h3>Background</h3><div>Subclinical hypothyroidism (SH) has been linked to an increased cardiovascular risk, though the specific contributing factors remain unclear.</div></div><div><h3>Methods</h3><div>We studied 120 consecutive adults with SH and 120 euthyroid controls matched for age, gender, and date of blood draw. Smoking status did not differ between groups. Groups were compared on clinical and laboratory data, lipid, insulin resistance (IR), glycemic, and liver steatosis/fibrosis indices, 10-year and lifetime cardiovascular risk (SCORE2, LIFE-CVD), as well as atherogenic and additional markers (lipoprotein(a), homocysteine, fibrinogen, highly sensitive C-reactive protein, apolipoproteins A1/B). A subset of individuals with SH and ≥TSH ≥10 mIU/L (n = 16) was followed up after L-thyroxine supplementation.</div></div><div><h3>Results</h3><div>SH subjects had a more adverse cardiovascular profile, with worse lipid, glycemic, IR, and hepatic markers, and higher 10-year (5.3 % vs. 4.1 % and 3.8 % vs. 2.8 %) and lifetime (28.5 % vs. 23.0 %) cardiovascular risk (all p < 0.05). Complementary markers were also elevated in SH (p < 0.01). Estimated absolute risk reductions from atorvastatin 20 mg were greater in SH (1.3 % vs. 0.9 % p = 0.008 and 7.7 % vs. 6.2 %, p < 0.001). The differences were more pronounced in severe SH (TSH ≥10). L-thyroxine led to modest risk amelioration (−0.21 % and −1.18 %), primarily owing to total/LDL cholesterol reductions.</div></div><div><h3>Conclusions</h3><div>SH is linked to a more adverse cardiovascular, metabolic and hepatic profile, indicating its potential as a candidate risk modifier. Intensive risk factor management is warranted, along with L-thyroxine supplementation in selected cases.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100394"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helicobacter pylori (H. pylori) infection is a globally prevalent gastrointestinal pathogen increasingly linked to various extra-gastric non-communicable diseases (NCDs). This review addresses the guiding question: What epidemiological and mechanistic links explain the association between H. pylori infection and chronic conditions such as cardiovascular disease (CVD), metabolic dysfunction-associated steatotic liver disease (MASLD), and type 2 diabetes mellitus (T2DM)?
The manuscript synthesizes evidence from epidemiological studies and mechanistic research. In CVD, H. pylori exacerbates chronic vascular inflammation, endothelial dysfunction, and autoimmune-like responses such as molecular mimicry. In MASLD, H. pylori induces insulin resistance (IR), hepatic inflammation, and microbiota-mediated liver injury, although findings remain inconclusive across populations. For T2DM, multiple pathways including NLRP3 inflammasome activation, hormonal imbalances (e.g., ghrelin, leptin), and immune-genetic interactions involving TLR4 and SOCS3 suggest a role for H. pylori in metabolic dysregulation and impaired glycemic control. While researchers have not yet fully elucidated causality, these findings indicate H. pylori as a potential modifiable risk factor for NCDs. Future longitudinal and interventional studies are warranted to determine whether eradication of H. pylori can mitigate chronic disease.
{"title":"Helicobacter pylori infection and association with chronic diseases: A focus on cardiovascular disease, MASLD, and type 2 diabetes","authors":"Navid Maleki , Alireza Mohammadzadeh , Jalal Mardaneh , Hossein Pazoki , Elyas Nattagh-Eshtivani","doi":"10.1016/j.metop.2025.100385","DOIUrl":"10.1016/j.metop.2025.100385","url":null,"abstract":"<div><div><em>Helicobacter pylori</em> (<em>H. pylori</em>) infection is a globally prevalent gastrointestinal pathogen increasingly linked to various extra-gastric non-communicable diseases (NCDs). This review addresses the guiding question: What epidemiological and mechanistic links explain the association between H. pylori infection and chronic conditions such as cardiovascular disease (CVD), metabolic dysfunction-associated steatotic liver disease (MASLD), and type 2 diabetes mellitus (T2DM)?</div><div>The manuscript synthesizes evidence from epidemiological studies and mechanistic research. In CVD, <em>H. pylori</em> exacerbates chronic vascular inflammation, endothelial dysfunction, and autoimmune-like responses such as molecular mimicry. In MASLD, <em>H. pylori</em> induces insulin resistance (IR), hepatic inflammation, and microbiota-mediated liver injury, although findings remain inconclusive across populations. For T2DM, multiple pathways including NLRP3 inflammasome activation, hormonal imbalances (e.g., ghrelin, leptin), and immune-genetic interactions involving TLR4 and SOCS3 suggest a role for <em>H. pylori</em> in metabolic dysregulation and impaired glycemic control. While researchers have not yet fully elucidated causality, these findings indicate <em>H. pylori</em> as a potential modifiable risk factor for NCDs. Future longitudinal and interventional studies are warranted to determine whether eradication of <em>H. pylori</em> can mitigate chronic disease.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100385"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-07-29DOI: 10.1016/j.metop.2025.100382
Salya F. Alfadli , Yazeed S. Alotaibi , Maha J. Aqdi , Latifah A. Almozan , Zahra B. Alzubaidi , Hammad A. Altemani , Shaden D. Almutairi , Hussain A. Alabdullah , Alaa Ahmed Almehmadi , Abdulrahman L. Alanzi , Ahmed Y. Azzam
Introduction
Continuous glucose monitoring (CGM) technologies have been advancing rapidly, but evidence on their comparative effectiveness stills limited to date yet. We conducted a systematic review and meta-analysis to evaluate and investigate the impact of CGM systems on glycemic control in adults with type 1 diabetes.
Methods
We searched electronic literature databases from inception through April 30, 2025, for comparative studies investigating CGM systems with standard monitoring or different CGM technologies in adults with type 1 diabetes. Primary outcomes included HbA1c reduction, time in range (TIR), and hypoglycemia reduction. We performed random-effects meta-analyses, network meta-analysis, and subgroup analyses by baseline HbA1c and intervention duration. Evidence quality was assessed using GRADE methodology.
Results
Twenty-seven studies with total of 2975 participants were included. CGM significantly reduced HbA1c compared to standard monitoring (mean difference: 0.38 %, 95 % CI: 0.49 to −0.27 %). TIR increased by 7.9 % (95 % CI: 5.8–10.0 %), representing 114 additional minutes daily in best range. Real-time CGM showed advantages over intermittently scanned CGM for TIR (+5.63 %, P-value<0.001) and hypoglycemia reduction (−1.28 %, P-value<0.001). Automated closed-loop systems achieved the highest ranking in network meta-analysis (SUCRA = 0.92). Benefits were greater among patients with higher baseline HbA1c (>8.5 %: 0.68 % reduction in HbA1c vs. <7.5 %: 0.24 % reduction in HbA1c, P-value = 0.009).
Conclusions
CGM technologies significantly improve glycemic control in adults with type 1 diabetes, with greater benefits for those with higher baseline HbA1c. Advanced systems demonstrate progressively greater improvements, with automated closed-loop systems showing the strongest evidence of effectiveness. These findings support broader implementation of CGM technologies, with selection tailored to individual patient needs.
{"title":"Effectiveness of continuous glucose monitoring systems on glycemic control in adults with type 1 diabetes: A systematic review and meta-analysis","authors":"Salya F. Alfadli , Yazeed S. Alotaibi , Maha J. Aqdi , Latifah A. Almozan , Zahra B. Alzubaidi , Hammad A. Altemani , Shaden D. Almutairi , Hussain A. Alabdullah , Alaa Ahmed Almehmadi , Abdulrahman L. Alanzi , Ahmed Y. Azzam","doi":"10.1016/j.metop.2025.100382","DOIUrl":"10.1016/j.metop.2025.100382","url":null,"abstract":"<div><h3>Introduction</h3><div>Continuous glucose monitoring (CGM) technologies have been advancing rapidly, but evidence on their comparative effectiveness stills limited to date yet. We conducted a systematic review and meta-analysis to evaluate and investigate the impact of CGM systems on glycemic control in adults with type 1 diabetes.</div></div><div><h3>Methods</h3><div>We searched electronic literature databases from inception through April 30, 2025, for comparative studies investigating CGM systems with standard monitoring or different CGM technologies in adults with type 1 diabetes. Primary outcomes included HbA1c reduction, time in range (TIR), and hypoglycemia reduction. We performed random-effects meta-analyses, network meta-analysis, and subgroup analyses by baseline HbA1c and intervention duration. Evidence quality was assessed using GRADE methodology.</div></div><div><h3>Results</h3><div>Twenty-seven studies with total of 2975 participants were included. CGM significantly reduced HbA1c compared to standard monitoring (mean difference: 0.38 %, 95 % CI: 0.49 to −0.27 %). TIR increased by 7.9 % (95 % CI: 5.8–10.0 %), representing 114 additional minutes daily in best range. Real-time CGM showed advantages over intermittently scanned CGM for TIR (+5.63 %, P-value<0.001) and hypoglycemia reduction (−1.28 %, P-value<0.001). Automated closed-loop systems achieved the highest ranking in network meta-analysis (SUCRA = 0.92). Benefits were greater among patients with higher baseline HbA1c (>8.5 %: 0.68 % reduction in HbA1c vs. <7.5 %: 0.24 % reduction in HbA1c, P-value = 0.009).</div></div><div><h3>Conclusions</h3><div>CGM technologies significantly improve glycemic control in adults with type 1 diabetes, with greater benefits for those with higher baseline HbA1c. Advanced systems demonstrate progressively greater improvements, with automated closed-loop systems showing the strongest evidence of effectiveness. These findings support broader implementation of CGM technologies, with selection tailored to individual patient needs.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100382"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-06-14DOI: 10.1016/j.metop.2025.100376
Ibrahim Ezuddin M. Almaski , Yazan Jumah Alalwani , Reem Salem Alshammari , Rayyan Mohammed A. Alassiri , Salman Ahmed S. Jathmi , Aishah Mohammed Alhadi , Amal Saleh Alzahrani , Mohammed Abdulwahed Alzahrani , Ahmed Y. Azzam , Tareq A. Maani
Introduction
Enhanced recovery after surgery (ERAS) protocols are evidence-based care improvement processes designed to minimize and reduce the negative physiological consequences of surgery. While previous studies have investigated ERAS in bariatric surgery, none have evaluated which specific components contribute most significantly to improved outcomes.
Methods
We performed a systematic review and meta-analysis following PRISMA 2020 guidelines. Six randomized controlled trials (RCTs) with total of 740 patients comparing ERAS protocols to standard care in bariatric surgery were included. We conducted component-specific meta-regression analysis of 14 individual ERAS elements, dose-response analysis across three implementation levels (low: ≤4 components, medium: 5–8 components, high: ≥9 components), and component clustering to identify synergistic combinations. Meta-regression was used to determine the relative impact of individual components on recovery and safety outcomes.
Results
Six RCTs including a total of 740 patients were included. Patients randomized to ERAS protocols have experienced significant reductions in nausea and vomiting (OR: 0.42, 95 % CI: 0.19–0.95, P-value = 0.040), intraoperative time (MD: 5.40, 95 % CI: 3.05–7.77, P-value<0.001), time to mobilization (MD: 3.78, 95 % CI: 5.46 to −2.10, P-value<0.001), intensive care unit length of stay (MD: 0.70, 95 % CI: 0.13–1.27, P-value = 0.020), total hospital stay (MD: 0.42, 95 % CI: 0.69 to −0.16, P-value = 0.002), and functional hospital stay (MD: 0.60, 95 % CI: 0.98 to −0.22, P-value = 0.002). Component-based analysis demonstrated that early mobilization, anti-emetic protocols, optimized anesthesia, and multimodal analgesia contributed most significantly to improved outcomes. We observed a clear dose-response relationship, with greater benefits in studies implementing more ERAS components.
Conclusion
ERAS protocols significantly improve recovery metrics following bariatric surgery, with certain components demonstrating greater impact than others. Early mobilization and anti-emetic protocols appear particularly beneficial, while the “Complete Recovery Bundle” demonstrates synergistic effects. We recommend a tiered implementation approach, prioritizing high-impact components, especially in resource-limited settings.
{"title":"Component-based approach of enhanced recovery after surgery protocols in bariatric surgery: A systematic review and meta-analysis of randomized controlled trials","authors":"Ibrahim Ezuddin M. Almaski , Yazan Jumah Alalwani , Reem Salem Alshammari , Rayyan Mohammed A. Alassiri , Salman Ahmed S. Jathmi , Aishah Mohammed Alhadi , Amal Saleh Alzahrani , Mohammed Abdulwahed Alzahrani , Ahmed Y. Azzam , Tareq A. Maani","doi":"10.1016/j.metop.2025.100376","DOIUrl":"10.1016/j.metop.2025.100376","url":null,"abstract":"<div><h3>Introduction</h3><div>Enhanced recovery after surgery (ERAS) protocols are evidence-based care improvement processes designed to minimize and reduce the negative physiological consequences of surgery. While previous studies have investigated ERAS in bariatric surgery, none have evaluated which specific components contribute most significantly to improved outcomes.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis following PRISMA 2020 guidelines. Six randomized controlled trials (RCTs) with total of 740 patients comparing ERAS protocols to standard care in bariatric surgery were included. We conducted component-specific meta-regression analysis of 14 individual ERAS elements, dose-response analysis across three implementation levels (low: ≤4 components, medium: 5–8 components, high: ≥9 components), and component clustering to identify synergistic combinations. Meta-regression was used to determine the relative impact of individual components on recovery and safety outcomes.</div></div><div><h3>Results</h3><div>Six RCTs including a total of 740 patients were included. Patients randomized to ERAS protocols have experienced significant reductions in nausea and vomiting (OR: 0.42, 95 % CI: 0.19–0.95, P-value = 0.040), intraoperative time (MD: 5.40, 95 % CI: 3.05–7.77, P-value<0.001), time to mobilization (MD: 3.78, 95 % CI: 5.46 to −2.10, P-value<0.001), intensive care unit length of stay (MD: 0.70, 95 % CI: 0.13–1.27, P-value = 0.020), total hospital stay (MD: 0.42, 95 % CI: 0.69 to −0.16, P-value = 0.002), and functional hospital stay (MD: 0.60, 95 % CI: 0.98 to −0.22, P-value = 0.002). Component-based analysis demonstrated that early mobilization, anti-emetic protocols, optimized anesthesia, and multimodal analgesia contributed most significantly to improved outcomes. We observed a clear dose-response relationship, with greater benefits in studies implementing more ERAS components.</div></div><div><h3>Conclusion</h3><div>ERAS protocols significantly improve recovery metrics following bariatric surgery, with certain components demonstrating greater impact than others. Early mobilization and anti-emetic protocols appear particularly beneficial, while the “Complete Recovery Bundle” demonstrates synergistic effects. We recommend a tiered implementation approach, prioritizing high-impact components, especially in resource-limited settings.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100376"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-08-05DOI: 10.1016/j.metop.2025.100383
Salya F. Alfadli , Yazeed S. Alotaibi , Maha J. Aqdi , Latifah A. Almozan , Zahra B. Alzubaidi , Hammad A. Altemani , Lama S. Alrashidi , Shaden D. Almutairi , Hussain A. Alabdullah , Alaa A. Almehmadi , Abdulrahman L. Alanzi , Ahmed Y. Azzam
{"title":"Corrigendum to “Effectiveness of continuous glucose monitoring systems on glycemic control in adults with type 1 diabetes: A systematic review and meta-analysis” [Metabol. Open 27 (2025) 100382]","authors":"Salya F. Alfadli , Yazeed S. Alotaibi , Maha J. Aqdi , Latifah A. Almozan , Zahra B. Alzubaidi , Hammad A. Altemani , Lama S. Alrashidi , Shaden D. Almutairi , Hussain A. Alabdullah , Alaa A. Almehmadi , Abdulrahman L. Alanzi , Ahmed Y. Azzam","doi":"10.1016/j.metop.2025.100383","DOIUrl":"10.1016/j.metop.2025.100383","url":null,"abstract":"","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100383"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-06-24DOI: 10.1016/j.metop.2025.100373
Eleni C. Pardali , Christos Cholevas , Odysseas Androutsos , Christina Tsigalou , Dimitrios Poulimeneas , Dimitrios P. Bogdanos , Maria Dalamaga , Dimitrios G. Goulis , Maria G. Grammatikopoulou
Obesity is characterized by the expansion of adipose tissue, contributing to systemic low-grade inflammation, insulin resistance, and widespread disruption of metabolic pathways. These pathophysiological changes are strongly linked to the development of several chronic conditions, including metabolic syndrome, type 2 diabetes, cardiovascular disease, and certain forms of cancer. Metabolomics have emerged as a powerful analytical approach for elucidating obesity-related metabolic disturbances at both the cellular and systemic levels, enabling the identification of specific metabolic signatures associated with disease risk and progression.
This narrative review synthesizes findings from interventional weight loss studies that addressed obesity using various strategies, including dietary modification, physical activity, pharmacotherapy, and bariatric surgery. Focusing on studies employing metabolomic techniques, this review highlights both consistent and divergent patterns in metabolite changes observed following weight loss, particularly in the metabolism of amino acids, lipids, short-chain fatty acids, and other metabolic pathways affected by each intervention. These insights have the potential to inform the development of more personalized and effective therapeutic approaches for obesity, thereby advancing the implementation of precision medicine in obesity management.
{"title":"Interventional approaches to combat obesity: Exploring the metabolomic signature of weight loss trials","authors":"Eleni C. Pardali , Christos Cholevas , Odysseas Androutsos , Christina Tsigalou , Dimitrios Poulimeneas , Dimitrios P. Bogdanos , Maria Dalamaga , Dimitrios G. Goulis , Maria G. Grammatikopoulou","doi":"10.1016/j.metop.2025.100373","DOIUrl":"10.1016/j.metop.2025.100373","url":null,"abstract":"<div><div>Obesity is characterized by the expansion of adipose tissue, contributing to systemic low-grade inflammation, insulin resistance, and widespread disruption of metabolic pathways. These pathophysiological changes are strongly linked to the development of several chronic conditions, including metabolic syndrome, type 2 diabetes, cardiovascular disease, and certain forms of cancer. Metabolomics have emerged as a powerful analytical approach for elucidating obesity-related metabolic disturbances at both the cellular and systemic levels, enabling the identification of specific metabolic signatures associated with disease risk and progression.</div><div>This narrative review synthesizes findings from interventional weight loss studies that addressed obesity using various strategies, including dietary modification, physical activity, pharmacotherapy, and bariatric surgery. Focusing on studies employing metabolomic techniques, this review highlights both consistent and divergent patterns in metabolite changes observed following weight loss, particularly in the metabolism of amino acids, lipids, short-chain fatty acids, and other metabolic pathways affected by each intervention. These insights have the potential to inform the development of more personalized and effective therapeutic approaches for obesity, thereby advancing the implementation of precision medicine in obesity management.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100373"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-07-01DOI: 10.1016/j.metop.2025.100378
Monica Peter , Mithra Balaji , Joe Varghese , Sam Marconi , Yesudhas Sudhakar , Felix Jebasingh , Padmanaban Venkatesan
Introduction
Diabetes in South Asians is driven primarily by impaired beta-cell function. When challenged with a high-calorie diet, this can result in metabolically unfavourable fat accumulation, which in turn worsens beta-cell function, thus constituting a vicious cycle. The investigators hypothesized that short-term mild-to-moderate weight loss induced by calorie restriction could break the cycle, resulting in significant improvements in beta-cell function. The objective of this study, therefore, was to evaluate the efficacy of a short-term weight loss program on body composition and beta-cell function.
Methods
As part of this quasi-experimental pre-post intervention study, 23 overweight normoglycemic participants underwent a low-calorie dietary intervention (∼1500 kcal/day) for a period of 4 weeks. Beta-cell function and insulin sensitivity were measured with a mixed meal challenge test (oral minimal model of glucose) before and after the intervention period. Changes in anthropometric parameters and body composition were also measured. The study was registered prospectively with the Clinical Trials Registry of India - CTRI/2023/04/051807 (https://ctri.nic.in/)
Results
Among the 23 participants in the study, 21 adhered to the intervention. The average weight loss was 3.5 % with an 11 % reduction in trunk fat mass. Beta-cell function, as measured by disposition index, increased by 128 % on average. Robust linear regression analysis showed that beta-cell function improved by 23 % for 1 % weight loss (P = 0.024).
Conclusion
A short-term mild-to-moderate weight loss in overweight normoglycemic subjects effectively improved their beta-cell function.
{"title":"Effect of short-term (4 weeks) low-calorie diet induced weight loss on beta-cell function in overweight normoglycemic subjects: A quasi-experimental pre-post interventional study","authors":"Monica Peter , Mithra Balaji , Joe Varghese , Sam Marconi , Yesudhas Sudhakar , Felix Jebasingh , Padmanaban Venkatesan","doi":"10.1016/j.metop.2025.100378","DOIUrl":"10.1016/j.metop.2025.100378","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetes in South Asians is driven primarily by impaired beta-cell function. When challenged with a high-calorie diet, this can result in metabolically unfavourable fat accumulation, which in turn worsens beta-cell function, thus constituting a vicious cycle. The investigators hypothesized that short-term mild-to-moderate weight loss induced by calorie restriction could break the cycle, resulting in significant improvements in beta-cell function. The objective of this study, therefore, was to evaluate the efficacy of a short-term weight loss program on body composition and beta-cell function.</div></div><div><h3>Methods</h3><div>As part of this quasi-experimental pre-post intervention study, 23 overweight normoglycemic participants underwent a low-calorie dietary intervention (∼1500 kcal/day) for a period of 4 weeks. Beta-cell function and insulin sensitivity were measured with a mixed meal challenge test (oral minimal model of glucose) before and after the intervention period. Changes in anthropometric parameters and body composition were also measured. The study was registered prospectively with the Clinical Trials Registry of India - CTRI/2023/04/051807 (<span><span>https://ctri.nic.in/</span><svg><path></path></svg></span>)</div></div><div><h3>Results</h3><div>Among the 23 participants in the study, 21 adhered to the intervention. The average weight loss was 3.5 % with an 11 % reduction in trunk fat mass. Beta-cell function, as measured by disposition index, increased by 128 % on average. Robust linear regression analysis showed that beta-cell function improved by 23 % for 1 % weight loss (P = 0.024).</div></div><div><h3>Conclusion</h3><div>A short-term mild-to-moderate weight loss in overweight normoglycemic subjects effectively improved their beta-cell function.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100378"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-08-24DOI: 10.1016/j.metop.2025.100388
Qiong Huang , Xiuben Du , Wenwei Ouyang , Jing Wang , Xusheng Liu
Background
Sarcopenic obesity (SO) combines reduced muscle mass and increased fat, elevating health risks in older adults. The triglyceride-glucose (TyG) index, a marker of insulin resistance, is associated with metabolic dysfunction. However, its role in predicting mortality in SO remains unclear. This study investigates the TyG index as a potential predictor of all-cause mortality in older adults with SO.
Methods
This study examined SO trends using data from 30,137 adults with dual-energy X-ray absorptiometry (DXA) and body fat measurements (1999–2018). For mortality analysis, 706 participants from NHANES 1999–2004 were included. Sarcopenia was defined according to the 2014 FNIH criteria. Statistical analyses, including Cox regression, cubic splines, and subgroup analyses, were employed to investigate the association between the TyG index and all-cause mortality in SO, as well as mortality variations among NHANES participants.
Results
Older age groups exhibit higher SO prevalence rates, with a notable upward trend in the >70 years group, while younger groups maintain lower rates. Trend analysis indicates no significant change from 1999 to 2006 but suggests a moderate, near-significant increase from 2011 to 2018. There was a U-shaped association between the TyG index and all-cause mortality. After full adjustment, adults in TyG group 1 (less than 3.25) had a 78.1 % higher risk (hazard ratio, 1.781; 95 % CI, 1.406–2.256; p < 0.001), and those in TyG group 5 (6.66 or greater) had a 74.5 % higher risk (hazard ratio, 1.745; 95 % CI, 1.211–2.516; p = 0.003) compared to the reference group (TyG group 3, 4.25 to 5.25). Subgroup analysis by age revealed that, among participants aged 70 and older, the group with the lowest mortality risk transitioned from Group 3 to Group 2. Furthermore, the analysis of varying mortality reveals that Group 5 (HR: 3.088; 95 % CI: 1.462–6.520; p = 0.003) is significantly associated with an increased risk of cardiovascular disease (CVD) mortality compared to Group 3. Similarly, TyG Group 1 demonstrates a significantly higher risk of mortality from other causes (HR: 2.253; 95 % CI: 1.207–4.206; p = 0.011) relative to Group 3. No significant associations are observed for malignant neoplasms, respiratory diseases, or cerebrovascular/Alzheimer's diseases.
Conclusion
This national cohort study identified a U-shaped association between the TyG index and all-cause mortality among SO patients, with increased risks observed at both low and high TyG levels. Age-specific analyses further reveal variations in this relationship, underscoring the importance of tailored strategies to enhance metabolic health and reduce mortality risks.
背景：肌少性肥胖（SO）结合了肌肉量减少和脂肪增加，增加了老年人的健康风险。甘油三酯-葡萄糖（TyG）指数是胰岛素抵抗的标志，与代谢功能障碍有关。然而，它在预测SO死亡率中的作用仍不清楚。本研究探讨了TyG指数作为老年SO患者全因死亡率的潜在预测因子。方法：本研究使用1999-2018年30137名成年人的双能x射线吸收仪（DXA）和体脂测量数据来研究SO趋势。死亡率分析纳入1999-2004年NHANES的706名参与者。骨骼肌减少症根据2014年FNIH标准定义。统计分析，包括Cox回归、三次样条和亚组分析，用于调查TyG指数与SO全因死亡率之间的关系，以及NHANES参与者之间的死亡率变化。结果各年龄组SO患病率较高，70岁年龄组患病率上升趋势明显，较年轻年龄组患病率较低。趋势分析表明，从1999年到2006年没有显著变化，但从2011年到2018年略有增加。TyG指数与全因死亡率呈u型相关。完全调整后，TyG组1（小于3.25）的成年人与参照组（TyG组3,4.25 ~ 5.25）相比，风险高78.1%（风险比1.781;95% CI, 1.406 ~ 2.256; p < 0.001）， TyG组5（6.66或更高）的成年人风险高74.5%（风险比1.745;95% CI, 1.211 ~ 2.516; p = 0.003）。按年龄进行的亚组分析显示，在70岁及以上的参与者中，死亡风险最低的一组从第3组过渡到第2组。此外，对不同死亡率的分析显示，与第3组相比，第5组（HR: 3.088; 95% CI: 1.462-6.520; p = 0.003）与心血管疾病（CVD）死亡率风险增加显著相关。同样，TyG组1的其他原因死亡风险明显高于组3 （HR: 2.253; 95% CI: 1.207-4.206; p = 0.011）。恶性肿瘤、呼吸系统疾病或脑血管/阿尔茨海默病未观察到显著相关性。这项全国性队列研究发现，在SO患者中，TyG指数与全因死亡率之间存在u型相关性，TyG水平高低均会增加风险。特定年龄的分析进一步揭示了这种关系的变化，强调了定制策略的重要性，以增强代谢健康和降低死亡风险。
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